Middle-aged and elderly men with urinary symptoms may not have a prostate problem
Posted Sep 16 2008 7:02am
When men middle-aged or elderly men have some difficulty with urination, their doctor’s attention will usually focus on their prostate – the gland that encircles the pipe that takes urine from the bladder to the outside (the urethra). An enlarged prostate can impinge on the outflow of urine from the bladder and therefore cause symptoms such as frequency (needing to pass water frequently), nocturia (getting up at night pass urine), hesitancy (having difficult getting urination going) and post micturition dribbling (‘leaking’ after urination).
However, I find it’s not uncommon for men to have urinary symptoms that do not stem from the prostate. Sometimes, urinary symptoms are the result of dysfunction in the bladder. Here, the bladder (which is essentially a muscular bag) can be ‘overactive’, and this can cause a symptom known as “urgency”, which basically means there is strong desire to urinate and the need to get to a toilet quickly. It’s not uncommon for individuals with this symptom to get caught short, giving rise to something known as “urge incontinence”.
Women are usually the prime suspects for urge incontinence, because childbirth is believed to have the ability to change the muscles at the base of the pelvis (pelvic floor muscles) in a way which can reduce continence. However, according to some sources (for example, here ), overactive bladder symptoms affect men and women equally, and this has certainly been my experience in practice.
By way of example, I saw a man last week with urinary symptoms, mainly of the “urgency” type. He had had his prostate investigated, and it had been concluded that while this was moderately enlarged, this might not actually explain his symptoms. Actually, in my opinion, his symptoms suggested an overactive bladder, which means his enlarged prostate may well be a red herring.
Over the years, I have discovered that an overactive bladder is very often related to a deficiency of the mineral magnesium. Magnesium is very important for normal muscular function, and a deficiency of it can cause muscles to be prone to spasm. So, this may cause the bladder to be overactive, but it can also cause symptoms in other muscles too including the skeletal muscles. Symptoms I look out for here are a tendency to cramp, tight muscles and ‘restless legs’ (a problem which tends to be most obvious when individuals are trying to get to sleep in bed at night). The man I saw last week was not a particular sufferer of cramp, but he had long-standing problems with muscular tension throughout his back, as well being prone to restless legs.
Part of the reason for me writing about this is that I noticed a study recently which attempted to look at the impact of an overactive bladder of quality of life . The researchers who performed this study found that individuals suffering from an overactive bladder tended to suffer more from a range other conditions and symptoms including constipation, asthma, diabetes, high blood pressure, bladder or prostate cancer, neurological conditions and depression. What I found interesting is that several of these health issues (namely constipation, asthma, diabetes, raised blood pressure and neurological symptoms) have links with magnesium deficiency. What this study may be demonstrating, therefore, is that individuals with symptoms of an overactive bladder may have it as a result of magnesium deficiency, and that this underlying problem may manifest as other symptoms too.
I generally recommend that individuals with symptoms of an overactive bladder try upping their magnesium intake, and this is especially the case where there are other symptoms suggestive of magnesium deficiency. Nuts are a good source of magnesium, though for speedier results I find it helps to supplement too at a dose of about 300 mg per day.
1. Coyne KS, et al. The impact of overactive bladder, incontinence and other lower urinary tract symptoms on quality of life, work productivity, sexuality and emotional well-being in men and women: results from the EPIC study. BJU International 2008;101(11):1388-1395